Date Established: Enter as mm/dd/yy (Example: 02/01/04)
Business Type:
Ownership Information:
SSN (NO DASHES)*
First, MI, Last:*
Address Line 1:*
City:*
State/Province:*
Zip/Postal Code:*
Home Phone:
Email:
Title:*
Ownership %:*
Cell Phone #:
Date of Birth:
Additional Owner Information:
SSN (NO DASHES)
First, MI, Last:
Address Line 1:
City:
State/Province:
Zip/Postal Code:
Home Phone:
Email:
Title:
Ownership %:
Cell Phone #:
Date of Birth:
We will obtain a consumer credit report about each person identified as a guarantor in this lease application. By clicking "Yes" in the "Credit Release Obtained" box above, the user providing us with guarantor information represents that (a) each guarantor has authorized the user to supply us with such information in this application and (b) each guarantor understands that we will obtain a consumer credit report about the guarantor in connection with this application.
Equipment Dealer Information
Vendor Name:
Address Line 1:
City:
State/Province:
Zip/Postal Code:
Phone #:
Fax #:
Equipment Information
Estimated Invoice Amount:
Equipment Description:
Credit Release Authorization
Credit Authorization: I/We hereby authorize ACG Equipment Finance, LLC, its designee, assigns or potential assigns to review his/her personal credit profile provided by national credit bureaus in considering this application and for the purpose of updating, renewing, extending additional credit or the collection of any late account. I/We hereby authorize our references to release all credit information and I/We represent and warrant that the information submitted herein is true, complete and accurate. A facsimile, electronic or other copy of this authorization shall be as valid as the original.
